Papillary thyroid cancer (PTC) is the most common endocrine malignancy. Despite good prognosis being generally associated with PTC, persistent/recurrent disease can be observed in a not negligible number of patients. Accurate postoperative management can lead to a significant improvement of risk stratification/staging of PTC patients identifying those at higher risk of a more aggressive clinical course. Molecular tests were introduced at the beginning of the 2000s to improve PTC risk stratification.
We reviewed the records of 354/1185 patients affected by low or low-to-intermediate risk unilateral-PTC. In these patients, BRAFV600E mutation was looked for and 131-radioiodine therapy was performed 3?months after thyroid surgery. A radioiodine post-therapeutic imaging was obtained in all patients.
BRAFV600E mutation was found in 170/354 PTC patients (female?=?126). Forty-two out of 170 BRAFV600E mutation +ve patients (female?=?27) had ipsilateral (n?=?24) or contralateral (n?=?18) loco-regional metastases onfirms that BRAFV600E mutation is associated with more aggressive PTC features and a higher prevalence of metastatic disease also in low or low-to-intermediate-risk PTC patients.18F-Fluorodeoxyglucose (FDG) PET/computerized tomography (CT) is a valuable method in the diagnosis of malignant pleural mesothelioma (MPM). But, some infections, particularly tuberculosis, are known to mimic cancer. We aimed to compare the FDG PET/CT findings of tuberculosis pleurisy (TP) and malignant mesothelioma and evaluate its role of differential diagnosis.
We retrospectively reviewed the data from 85 patients (45 patients with MPM and 40 patients with TP) who underwent FDG PET/CT. All images were reevaluated and pleural thickening, maximum standardized uptake values (SUVmax), lymphatic uptake and accompanying parenchymal findings were noted.
There was no significant difference in age and sex between the two groups. Pleural thickening was more prominent in the MPM group. Mean pleural thickness was 21.4 ± 18.6 mm in the MPM group and 6.8 ± 3.5 mm in the TP group (P = 0.0). Besides pleural pathology, lymph nodes involvement in the thoracic (P = 0.0) and extrathoracic area (P = 0.34) and parenchymal findings were prominent in the TP group (P = 0.0). However, there was no significant difference in pleural SUVmax values between the two groups (P = 0.61).
Intense pleural FDG uptake can be observed in TP like malignant mesothelioma. For the evaluation of the pleural pathologies in the tuberculosis endemic countries, it should be considered that FDG PET/CT may have false-positive results. Evaluation of increased pleural FDG uptake together with the detected parenchymal findings and lymphatic involvement may help us to make more accurate interpretation of the diagnosis.
Intense pleural FDG uptake can be observed in TP like malignant mesothelioma. For the evaluation of the pleural pathologies in the tuberculosis endemic countries, it should be considered that FDG PET/CT may have false-positive results. Evaluation of increased pleural FDG uptake together with the detected parenchymal findings and lymphatic involvement may help us to make more accurate interpretation of the diagnosis.We compared the diagnostic performance of C-11 acetate and F-18 fluorodeoxyglucose (FDG) PET/computed tomography (CT) for the detection of extrahepatic metastasis in patients with hepatocellular carcinoma (HCC) and evaluated whether the improvement in the diagnostic performance of dual tracer PET/CT differs by the metastatic site.
Fifty-eight patients who had extrahepatic metastasis on either C-11 acetate or F-18 FDG PET/CT were enrolled, and 193 metastatic lesions were analyzed in this retrospective study. The metastatic lesions were categorized based on six sites of involvement. According to each involved site, the tracer avidity of the metastatic lesions was compared using the maximum standardized uptake value (SUVmax).
Bone was the most frequent categorized metastatic site (44.8%), followed by lymph node (39.7%), lung (34.5%), soft tissue (27.6%), adrenal gland (6.9%), and vascular category (3.4%). C-11 acetate PET/CT showed a higher SUVmax than F-18 FDG PET/CT in metastatic bone lesions (P?=?0.003). F-18 FDG uptake was significantly higher than C-11 acetate uptake in metastatic lymph node lesions (P?&lt;?0.001). The detection rate of dual tracer PET/CT was significantly higher in the metastatic lung (93.6%) and soft tissue (100%) lesions. However, the diagnostic performance of dual tracer PET/CT was limited in the metastatic bone and lymph node lesions because each tracer's detection rate was very high (bone 94.6% in C-11 acetate, lymph node 94.1% in F-18 FDG).
The tracer avidity of metastatic lesions differed according to the involved site. This difference affected the complementary role of dual tracer PET/CT in the diagnosis of extrahepatic metastases in patients with HCC.
The tracer avidity of metastatic lesions differed according to the involved site. This difference affected the complementary role of dual tracer PET/CT in the diagnosis of extrahepatic metastases in patients with HCC.In 1978, O'Reilly introduced the diuretic renogram using the F?+?20 method. Initially, the patient was examined in the seated position. A dose of 40 mg furosemide was injected intravenously 20?min following tracer injection and dynamic acquisition was prolonged for 15-20?min. In 1992, the guidelines suggested to study patients in the supine position to avoid risk of diuretic-induced hypotension and reduce patient movement. Unfortunately, equivocal findings were reported in 15-30% of cases. Side effects such as bladder fullness and disruption because of voiding were reported. Several methods had been proposed in the supine position, such as the well-tempered diuretic renogram F?+?20, F?-?15, F0 and F?+?2, with different time in minute of diuretic administration in relation to tracer injection. However, as confirmed by many studies, there was no clear evidence suggesting superiority among these methods. https://www.selleckchem.com/products/6-aminonicotinamide.html We suggest using the diuretic renogram with the F?±?10(sp) method for the diagnosis of obstruction in adult patients with hydronephrosis and for the follow-up in patients who underwent a surgical treatment of the urinary tract.